Survival Up for CABG With Surgical Ablation in Atrial Fibrillation
FRIDAY, June 13, 2025 -- Medicare beneficiaries with preexisting atrial fibrillation undergoing coronary artery bypass grafting (CABG) who undergo concomitant surgical ablation have a survival advantage, according to a study published online June 3 in the Annals of Thoracic Surgery.
Justin M. Schaffer, M.D., from Baylor Scott & White - The Heart Hospital in Plano, Texas, and colleagues identified 87,699 Medicare beneficiaries with preexisting atrial fibrillation undergoing CABG, with or without concomitant surgical ablation, from 2008 to 2019. All-cause mortality and stroke incidence were assessed as separate end points. Overlap propensity score weighting adjusted for measured confounding variables.
Overall, 22.2 percent of the beneficiaries with atrial fibrillation undergoing CABG underwent concomitant surgical ablation. During CABG, 1,193, 1,834, and 652 surgeons infrequently, occasionally, and frequently performed ablation, respectively (<5 percent, ≥5 but <40 percent, and ≥40 percent, respectively). The researchers found that in an as-treated analysis, beneficiaries undergoing surgical ablation had a risk-adjusted median survival advantage of 4.40 months compared to those without (7.82 versus 7.46 years, respectively). The risk-adjusted median survival advantage was 4.96 months for beneficiaries undergoing CABG by surgeons who frequently ablate versus those who infrequently ablate (7.03 versus 6.62 years).
"This study is one of several recent analyses suggesting that surgical ablation may meaningfully improve survival in patients with preexisting atrial fibrillation undergoing CABG," Schaffer said in a statement. "Our analysis found that the treatment effect of surgical ablation for atrial fibrillation manifested late, over two years after CABG."
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